Active NPI
Sondra Beres, PHD
- Marriage & Family Therapist
- Edmonds, WA
National Provider Identifier
1568765170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LF60975646
- Practice address
- 300 Admiral Way Ste 203
Edmonds, WA 98020 - Phone
- (425) 789-1073
- NPI assigned
- Dec 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 560 | CO | |
| Marriage & Family Therapist | 106H00000X | LF60975646 | WA | Primary |
Addresses
Primary practice location
300 Admiral Way Ste 203
Edmonds, WA 98020
Mailing address
7909 218TH St SW Apt 6
Edmonds, WA 98026-7964
Phone (669) 210-6460
Other practice location 1
445 Union Blvd
Ste 302
Lakewood, CO 80228-1237
Phone (303) 385-7746
Other practice location 2
445 Union Blvd
Ste 302
Lakewood, CO 80228-1237
Phone (303) 385-7746
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LF60975646 | WA | MD | Marriage & Family Therapist |
| 560 | CO | MD | Athletic Trainer |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Snohomish Psychology Associates, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Everett, WA
- NPI 1497178206
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569283200000",
"number": "1568765170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7909 218TH ST SW APT 6",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267964",
"telephone_number": "669-210-6460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 ADMIRAL WAY STE 203",
"city": "EDMONDS",
"state": "WA",
"postal_code": "98020",
"telephone_number": "425-789-1073"
}
],
"practiceLocations": [
{
"address_1": "445 Union Blvd",
"address_2": "Ste 302",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "CO",
"postal_code": "802281237",
"country_code": "US",
"telephone_number": "303-385-7746",
"fax_number": "303-635-1363",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "445 Union Blvd",
"address_2": "Ste 302",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "CO",
"postal_code": "802281237",
"country_code": "US",
"telephone_number": "303-385-7746",
"fax_number": "303-635-1363",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BERES",
"first_name": "SONDRA",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-21",
"last_updated": "2019-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "560",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LF60975646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.